Fighting Addiction

By Sandra Howe
Staff Writer

Women who give birth to "crack babies" have been called selfish, amoral, uncaring and inhumane - and worse. But Asst. Prof. Margaret Kearney (SON) refutes those stereotypes in her article "Salvaging Self: A Grounded Theory of Pregnancy on Crack Cocaine," recently published in the Journal of Nursing Research .

Prompted by the horrific descriptions of crack-addicted mothers and misleading information in media coverage of the issue, Kearney studied female crack users and how they responded to pregnancy. Interviewing 60 women who reported crack usage of at least once a week while pregnant, she found they possessed a strong set of values and often tried to make changes in their lifestyles during their pregnancies. In the course of her study, Kearney also developed recommendations for improving the quality of life for mother and child, both before and after birth.

"In all the negative publicity, nobody has asked the mothers what's going on in their lives, so I wanted to look at the situation from their perspective and bring out their side of the story," she said. "Some faced such obstacles that they didn't succeed, but they still had the same mainstream goals as the rest of us: to protect their unborn child from harm and prepare to be as good a mother as they could be."

Most of the women in the study, which was funded by the National Institute for Drug Abuse, were on public assistance - 85 percent - with a mean age of 28. Kearney said they saw their pregnancies as a chance to pull their lives together, because suddenly they had to think of someone beyond themselves.

"So even if their self-concepts were battered and they felt as if they weren't worth any investment, a child made them reassess their situation and try to restructure their lives," she said.

Through a process of "salvaging self," Kearney said, many mothers attempted to redirect their lives by eating better, getting rest and going to a doctor. In addition, almost all in the sample quit or cut back on crack use, or switched to what they perceived as less dangerous drugs - such as amphetamine or marijuana - during their pregnancy.

If the media's image of crack mothers differs from reality, Kearney notes that their reporting is erroneous or incomplete in other respects as well: Crack is not addictive to newborns, she says, and the low birth weight associated with crack babies is usually due to the alcohol and tobacco their mothers often use in conjunction with crack. She adds that while the children face an uphill struggle, they can reach normal developmental milestones with proper nurturing.

Kearney's findings also shed light on why addicted mothers often do not obtain proper prenatal care. Heavy drug users, for example, are often so immersed in their habit that they may not discover they are pregnant until well after conception. Others spend months deciding whether they will keep the baby and thus delay prenatal care, while those who cannot quit their drug habit avoid seeking care because they fear discovery by authorities who would take the child away.

To encourage more women to seek prenatal care, Kearney suggests reducing penalties for disclosing drug use and leniency for those who enter drug treatment programs. Health providers also should protect the confidentiality of prenatal records to increase the likelihood that expectant mothers will make regular visits, she said.

Acknowledging that not all women can quit their habit, Kearney suggests implementing techniques to minimize the negative effects of drugs. For example, many women consume large amounts of alcohol - a proven danger to fetuses - to help them "come down" from a crack high. Research on other, less harmful drugs that perform the same function would therefore be beneficial, she said. She would also like to see authorities provide more opportunities for women to participate in drug treatment programs with their babies, rather than removing the infant from custody until the mother is reformed.

"I have a sense of admiration on how far these women were willing to go to make their life better for their kids," said Kearney, who will next undertake a two-year study on mothers attempting to stay off drugs. "They put themselves on the line for the sake of their kids and themselves as parents, and were seeking to salvage their own lives for the sake of their infants' well-being."